Outcome of single-chamber, ventricular pacemakers with transvenous leads implanted in children

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Aims: In children with bradyarrhythmias, ventricular demand, rate-responsive pacemakers (VVI/R PM) are often indicated, but no study is entirely dedicated to their outcome. Methods and results: We evaluated the outcomes of children with VVI/R PM implanted at our centre, with a retrospective analysis. Between 1990 and 2005, 117 children (63 with congenital heart defects), received VVI/R PM with endocardial lead at 5.3 ± 3.9 years of age for atrioventricular block (n = 105) and sinus node dysfunction. The majority of the leads were unipolar (n = 78), tined (n = 110), and steroid eluting (n = 89). The leads were fixed to subcutaneous tissues by absorbable suture in all patients; in 17 patients, also an atrial loop was created. Follow-up (FU) was 7.8 ± 4.1 years. There were 22 system failures (19%), due to lead malfunction (n = 20) and system erosion/infection. The log-rank test for equality of survivor functions showed no significant risk factor. However, lead malfunction occurred only in the group without loop, but FU duration was longer in these patients. Complications at implantation were haemothorax (2.5%) and lead dislodgement (5%). Clinically silent occlusion of the subclavian vein was documented at FU by Echo-Doppler in 5%. Conclusion: In this particular group of patients, VVI/R pacing has good results, but after long-term FU shows 19% of failures, mainly lead-related.

Original languageEnglish
Pages (from-to)894-899
Number of pages6
JournalEuropace
Volume9
Issue number10
DOIs
Publication statusPublished - Oct 2007

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Hemothorax
Sick Sinus Syndrome
Subclavian Vein
Congenital Heart Defects
Atrioventricular Block
Subcutaneous Tissue
Bradycardia
Sutures
Survivors
Steroids
Infection
Lead

Keywords

  • Cardiac pacing
  • Children
  • Endocardial pacing
  • Pacemaker
  • Pacing complications
  • Ventricular demand pacing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Outcome of single-chamber, ventricular pacemakers with transvenous leads implanted in children. / Silvetti, Massimo Stefano; Drago, Fabrizio; Marcora, Simona; Ravà, Lucilla.

In: Europace, Vol. 9, No. 10, 10.2007, p. 894-899.

Research output: Contribution to journalArticle

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abstract = "Aims: In children with bradyarrhythmias, ventricular demand, rate-responsive pacemakers (VVI/R PM) are often indicated, but no study is entirely dedicated to their outcome. Methods and results: We evaluated the outcomes of children with VVI/R PM implanted at our centre, with a retrospective analysis. Between 1990 and 2005, 117 children (63 with congenital heart defects), received VVI/R PM with endocardial lead at 5.3 ± 3.9 years of age for atrioventricular block (n = 105) and sinus node dysfunction. The majority of the leads were unipolar (n = 78), tined (n = 110), and steroid eluting (n = 89). The leads were fixed to subcutaneous tissues by absorbable suture in all patients; in 17 patients, also an atrial loop was created. Follow-up (FU) was 7.8 ± 4.1 years. There were 22 system failures (19{\%}), due to lead malfunction (n = 20) and system erosion/infection. The log-rank test for equality of survivor functions showed no significant risk factor. However, lead malfunction occurred only in the group without loop, but FU duration was longer in these patients. Complications at implantation were haemothorax (2.5{\%}) and lead dislodgement (5{\%}). Clinically silent occlusion of the subclavian vein was documented at FU by Echo-Doppler in 5{\%}. Conclusion: In this particular group of patients, VVI/R pacing has good results, but after long-term FU shows 19{\%} of failures, mainly lead-related.",
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